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Healthcare workers’ shortage and migration: consequences for our health systems' sustainability.

Healthcare Workers' Migration is one of the biggest challenges, which the European healthcare systems currently face. But its dire consequences affect not only the healthcare systems, but are also important factors for the healthcare workers themselves.

 

The Problem:

The world and particularly Europe faces an important shortage of healthcare workers. Indeed, at a time where the healthcare services’ demand is constantly growing with an ageing population, the need for healthcare workers increases more than ever. However health systems struggled to attract healthcare workers. The qualifications required, the long working hours and the poor financial recognition are some of the elements explaining the lack of vocations from young professionals. This shortage of healthcare professionals is becoming particularly a problem for Eastern European countries which see their workforce going away, looking for better work conditions. Indeed, nurses, midwives, doctors and medical specialists in the new Member States have usually lower salaries, lesser career and training opportunities and this sometimes leads to them migrating to Western European countries, which can offer better salaries, better working conditions and prospects. This tendency is accentuated by the fact that richer countries try to fill their lack of qualified healthcare workers by offering incentives to Eastern European workers. This has led to a healthcare workforce crisis in many Eastern European countries, with sometimes fatal consequences; some clinics and/or medical institutions have been forced to close as standards of care could no longer be guaranteed. This shortage of workers in Western Europe will not be solved by attracting other countries’ workforce. It is a global problem requiring long term solutions and investment in training and education. Healthcare workers’ mobility is not the solution to this crisis. The world and particularly Europe need more health professionals! We therefore need to invest massively in educating and forming young professionals and also implement solutions to retain them.

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Political Initiatives:

The institutions of the European Union have started realising the importance of this challenge. Several Members of the European Parliament as well as officials from the European Commission have shown their awareness of the problem and their readiness to tackle this probelm at several events held in the Brussels health landscape.

The upcoming Green Paper “The European Health Workforce – Promoting a Sustainable Workforce in Europe”, which is announced for the end of the year, will probably be the first major policy initiative at the European level to tackle the problem.

In March 2008, the Global Health Workforce Alliance, a coalition of international healthcare workers under the umbrella of the WHO, agreed on the Kampala Declaration and on an Agenda for Global Action, which describes the problem of healthcare workers’ shortage and migration. The Declaration calls for firm policy initiatives. 

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Relevent reports, documents and links:

"Health Worker Migration in the European Region: Country Case Studies and Policy Implications"
Report by WHO Europe about the migration of healthcare workers in Europe.
http://www.euro.who.int/document/e88366.pdf

"European Federation of Nurses Associations (EFN): Good Practice Guidance for International Nurse Recruitment"
A small booklet which gives information for nurses who are thinking about working in a different country, but also for hospitals or employees who are thinking about recruiting healthcare workers abroad.
http://www.efnweb.org/version1/en/documents/EFNGoodPracticeGuidanceforRecruitment.doc

OECD Report on Migration: "A Profile of Immigrant Populations in the 21st Century: Data from OECD Countries"
This report gives lots of statistics about migration in the OECD countries in general, but also some specific information about healthcare workers migration; you need a special subscription or to purchase the publication to be able to view the data.
http://www.oecd.org/document/27/0,3343,en_2649_37415_40110299_1_1_1_37415,00.html

WHO Global Health Workforce Alliance
"Scaling Up, Saving Lives - Task Force for Scaling Up Education and Training for Health Workers" 
http://www.who.int/workforcealliance/en/

Global Health Workforce Alliance, 2008
http://www.who.int/workforcealliance/documents/Global_Health%20FINAL%20REPORT.pdf

Global Health Workforce Alliance: Kampala Declaration "Health Workers for All and All for Health Workers"
http://www.who.int/entity/workforcealliance/Kampala%20Declaration%20and%20Agenda%20web%20file.%20FINAL.pdf

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Related events and organizations on the European level:

Migration: Challenges and Opportunities for Health Systems in Europe and beyond
Report by the International Center for Migration and Health, the European Medical Association and the Taiwan Representative Office in the EU
http://www.emanet.org/docs/migration_challenges_and_opportunities_for_health_systems.pdf

The European Federation of Public Service Unions (EPSU) and the European Hospital and healthcare Employers' Association (HOSPEEM) agreed on a code of conduct and follow up on Ethical Cross-Border Recruitment and Retention in the Hospital Sector
http://www.epsu.org/a/3715

A Report from an European Parliament event on migration of healthcare workers organized by the European Federation of Public Service Employees (EUROFEDOP)
http://www.healthfirsteurope.org/uploads/documents/pub-36_en-breakfast_migration_health_professionals_2006_11_22_en.pdf

First meeting of the Coalition for Health Ethics and Society on the issue of "Health professionals' migration"
http://www.epc.eu/en/iwp1.asp?TYP=TEWN&LV=187&see=y&PG=TEWN/EN/CHESS1&l=14

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